黄世敬教授基于脑肾相济论辨治缺血性脑白质病的经验

Experience of Professor Huang Shijing’s differential treatment of white matter ischemic lesions based on the theory of brain and kidney

缺血性脑白质病是老年人群脑部常见病理改变,与高血压、认知功能下降、缺血性卒中等密切相关,目前仍未发现有效干预措施。黄世敬教授通过多年的临床观察与实践,总结出缺血性脑白质病发生发展的病理基础为“肾虚髓亏、痰阻血瘀”,而“脑肾失济”是其发病重要环节。围绕这一病机,黄教授提出在“补肾填髓,化痰祛瘀”的基础上,要尤其重视“交通脑肾”在治疗中的作用。临床收效颇多,为多种脑病防治提供了新的思路。本文结合文献研究系统阐述黄世敬教授基于脑肾相济论辨治缺血性脑白质病的经验。

White matter ischemic lesions is a common pathological change in the brain of the elderly,which is closely related to hypertension,cognitive decline,and ischemic stroke.At present,no effective intervention has been found.Professor Huang Shijing has observed and practiced for many years.It is concluded that the pathological basis of the occurrence and development of ischemic leukoencephalopathy is“kidney deficiency,phlegm blocking blood stasis”,and“brain and kidney failure”is an important part of its pathogenesis.Centering on this pathogenesis,it is proposed that special attention should be paid to the role of“communicating brain and kidney”in treatment on the basis of“tonifying kidney and filling marrow,resolving phlegm and removing blood stasis”.A lot of clinical results have been achieved,which provides a new idea for the prevention and treatment of many kinds of encephalopathies.This paper systematically expounds Professor Huang Shijing’s experience in differential diagnosis and treatment of ischemic leukoencephalopathy based on the theory of brain and kidney.